Sanitation is the theme of this year’s World Water Day (March 20). UN development agencies are calling for greater public awareness and donor support for improving sanitation in the developing world – where, for example, more than two billion people lack access to toilets. From Washington, VOA’s William Eagle reports on the some of the sanitation needs cited in sub-Saharan Africa.

Safe water and sanitation are rare in much of Africa. UN sources say less than 40 percent of all Africans have access to acceptable facilities for the disposal of human waste. Instead, in some of Africa’s overcrowded cities, plastic bags of waste, called “flying toilets,” are thrown into ditches and open sewers. In rural areas, less than a third of the people have access to toilets or latrines that efficiently separate waste from drinking water. As a result, many people defecate in open fields.

The result can be deadly: UNICEF says diarrheal diseases, mostly caused by poor sanitation and hygiene, kill nearly two million people around the world every year, including 5,000 children a day.Many of those affected are African.

Two girls wash their hands at an outdoor tap at the Catholic primary school in Busamana village, Rwanda (UNICEF)

The UN says investing in improved sanitation could reduce those deaths by two-thirds. It could also lead to economic growth.

“It’s been estimated that every dollar spent on sanitation [generates] nine dollars in the form of improved productivity and economic activity from [healthy] people who would be able to be working and from some savings in health [because people] would not be sick,” says Pat Dandonoli, the president and chief executive of WaterAid America.

Dandonoli says water-related NGOs and U.N. agencies like UNICEF are making progress in improving sanitation.

She says the effort involves introducing sustainable methods that will be supported by local communities.

“Sometimes you have to overcome some longstanding cultural conditions,” says Dandonoli, “to get the community to see the value and benefits of improved sanitation – like the proper disposals of waste, which is usually underground. In some rural communities in Madagascar, there are taboos against burying [waste] because of the concern about contaminating the ground in which ancestors are buried.”

Development groups are working to create consumer demand for improved facilities, rather than donate toilets and latrines that may not be used. Local businesses are encouraged to meet the demand for concrete slabs or other materials needed to build latrines.

According to Dandonoli, “What we are finding is there is not a business model in place for people to see they can economically make the parts that are needed to construct a latrine and see there is sufficient demand for these products.”

“Something that WaterAid with its partners tries to do,” she continues, “is to stimulate and get involved with small scale private sector players to build the sustainability of the system. [That’s] because international aid and development assistance are not long term solutions – [the answer is] to have a market for these businesses to supply services and materials that people want at a price they can afford. That is a bit of a challenge in sanitation, but we are trying to stimulate and look for ways for those approaches to take hold.”

Concrete slabs form the foundation of a latrine in Araromi Oke Village in Ekiti State, Nigeria (UNICEF)

The effort to increase demand also includes a campaign to change behavior – that is, to educate the public about regularly washing hands and disposing of human waste safely.

The strategy has been successful in Bangladesh and Ethiopia. Elsewhere in Africa, the effort to create public demand is being introduced in Nigeria, Sierra Leone and Zambia.

Women are an important part of the strategy.

Clarissa Brocklehurst, the chief of water, environment and sanitation at UNICEF, says rural women are allies in the fight for better sanitation, in part because it is dangerous for them to go alone into the fields, especially at night. And, Brocklehurst says they want their daughters to have access to separate facilities at school. Many girls, especially after the onset of menstruation, leave school if they don’t have a way to havethe privacy needed to practice good hygiene.

“So in a community,” says says, ” [there is] the impetus of committed women who say it is no longer acceptable for anyone in village not to have a toilet…. There is peer pressure on every household to do something to build [one]. This is an approach in which women’s commitment to push a community to take action is very, very important.”

Pat Dandonoli of WaterAid says the development community is working to improve funding and to encourage a renewed commitment to sanitation from national governments. They’re also working on the local level to help officials identify effective ways of improving sanitation and coordinating support with the provincial or national government.

She says she’s pleased that Japan, the host of the next G-8 summit, has agreed to include water and sanitation on the agenda when the world’s largest industrialized nations meet later this year. The U.N. has declared 2008 the International Year of Sanitation.

The development community is also working to engage the private sector in improving sanitation, which is one of the UN’s Millennium Development Goals. By 2015, the organization wants to cut in half the number of people worldwide needing access to improved sanitation. The UN estimates the effort will cost $10 billion a year. Experts say that’s a small amount for the tens of billions of dollars worth of improved productivity that would come from improved hygiene and sanitation.